本文選題：胃癌 + 性別�。� 參考：《新鄉(xiāng)醫(yī)學(xué)院》2016年碩士論文

【摘要】：背景胃癌是發(fā)生于胃上皮組織的惡性腫瘤,是全世界最常見(jiàn)的惡性腫瘤之一。據(jù)統(tǒng)計(jì),全球每年新發(fā)胃癌約有100萬(wàn)例,同時(shí)每年約有60萬(wàn)人因胃癌死亡,居于所有癌癥死因的第二位。因此,早發(fā)現(xiàn)、早治療、進(jìn)行早期干預(yù)是提高患者生存期的重要手段。大量文獻(xiàn)針對(duì)老年胃癌患者和青年胃癌患者的臨床病理特征進(jìn)行了對(duì)比研究,但是鮮有針對(duì)中年胃癌患者的研究,而是籠統(tǒng)地把中年人歸于中老年人的范疇。目的探討不同性別及年齡組胃癌患者的臨床病理特點(diǎn),從個(gè)體化的視角來(lái)研究青年男性、中年男性和老年男性各組之間的差異以及青年女性、中年女性和老年女性各組之間的差異,尤其把中年胃癌患者作為一個(gè)獨(dú)立的研究對(duì)象,旨在通過(guò)更加細(xì)化的分類(lèi)方法來(lái)進(jìn)行更加具有針對(duì)性的研究,以期能為胃癌的預(yù)防和診療提供較為全面且更有針對(duì)性的依據(jù)。方法回顧性分析許昌市中醫(yī)院2014年01月至2015年01月確診的263例胃癌患者的臨床資料,依據(jù)性別及2000年WHO對(duì)于年齡的界定范圍,分為青年男性組、中年男性組和老年男性組以及青年女性組、中年女性組和老年女性組。從個(gè)體化的視角來(lái)分析許昌地區(qū)青年男性、中年男性和老年男性各組之間的臨床病理差異以及青年女性、中年女性和老年女性各組之間的臨床病理差異。采用SPSS17.0對(duì)青年男性組、中年男性組和老年男性組三組數(shù)據(jù)進(jìn)行分析,如差異具有顯著性,再進(jìn)行兩兩對(duì)比,明確差異的來(lái)源,同樣的方法也應(yīng)用于女性各年齡組。結(jié)果1.本研究中,263例胃癌患者,男性186例,女性77例,男女性別構(gòu)成比為2.41:1。其中青年男性11例,青年女性16例,男女構(gòu)成比為1:1.45;中年男性82例,中年女性26例,男女構(gòu)成比為3.15:1;老年男性93例,老年女性35例,男女構(gòu)成比為2.66:1。2.在病變部位上,總體來(lái)看,許昌地區(qū)胃癌患者發(fā)病部位的排序?yàn)槲父]賁門(mén)胃底胃體全胃。老年男性胃體部發(fā)病率高于中年男性,兩組之間比較差異有統(tǒng)計(jì)學(xué)意義(p0.05);其余男性患者各年齡組在各部位的發(fā)病率上無(wú)顯著性差異(p0.05)。女性患者各年齡組在各部位的發(fā)病率上均無(wú)顯著性差異(p0.05)。3.在大體分型上,許昌地區(qū)中年男性組在borrmannⅡ型的構(gòu)成比上顯著高于老年男性組(p0.05)。女性患者各年齡組在大體分型的構(gòu)成比上均無(wú)顯著性差異(p0.05)。4.在組織學(xué)分型上,許昌地區(qū)老年男性組中分化腺癌的構(gòu)成比顯著高于青年男性組和中年男性組(p0.05);青年男性組在粘液腺癌的構(gòu)成比上顯著高于老年男性組(p0.05)。女性患者中,青年女性組在未分化癌的構(gòu)成比上顯著高于老年女性組(p0.05)。5.在病理分期上,許昌地區(qū)青年男性組在tnm分期中Ⅲ期的構(gòu)成比上顯著高于中年男性組(p0.05)。女性患者中,各年齡組女性在各tnm分期的構(gòu)成比上無(wú)顯著性差異(p0.05)。6.在臨床表現(xiàn)上,總體來(lái)看,許昌地區(qū)胃癌患者最常見(jiàn)的臨床表現(xiàn)是腹痛,其次是食欲不振、嘔血黑便等。中年男性組上腹疼痛的發(fā)生率高于青年男性組和老年男性組(p0.05);老年男性組消瘦的發(fā)生率顯著高于中年男性組(p0.001);老年男性組吞咽困難的發(fā)生率顯著高于中年男性組(p0.001)。女性患者中,老年女性組消瘦的發(fā)生率高于中年女性組,(p0.05);其余各年齡組女性在各種臨床表現(xiàn)的發(fā)生率上無(wú)顯著性差異(p0.05)。7.在家族史、吸煙史及飲酒史上,許昌地區(qū)男性各組間及女性各組間均無(wú)顯著性差異(p0.05)。8.在高血壓、糖尿病等合并癥上,許昌地區(qū)男性各組間及女性各組間均無(wú)顯著性差異(p0.05)。結(jié)論1.許昌地區(qū),男性胃癌發(fā)病率高于女性,中年胃癌患者男女構(gòu)成比最高,青年人胃癌女性顯著高于男性。2.許昌地區(qū)青年患者,尤其青年女性患者胃癌的組織形態(tài)、生物學(xué)行為均顯著差于中老年患者;中年患者病灶較局限;中年患者的腹痛癥狀以及老年患者的消瘦和吞咽困難癥狀較為顯著。
[Abstract]:Background gastric cancer is a malignant tumor occurring in the epithelial tissue of the stomach. It is one of the most common malignant tumors in the world. According to statistics, there are about 1 million cases of new gastric cancer in the world every year. At the same time, about 600 thousand people are died of gastric cancer each year, and second of all the causes of cancer death are in the world. Therefore, early detection, early treatment and early intervention are to improve the survival period of the patients. The clinicopathological features of the elderly gastric cancer patients and young gastric cancer patients were compared in a large number of literatures, but there were few studies on the middle aged gastric cancer patients, but in general, the middle-aged people were classified in the category of middle aged and old people. To study the differences between young men, middle-aged men and older men, and the differences between young women, middle-aged women and older women, especially middle-aged patients with gastric cancer as an independent study, aimed at making more specific research through a more detailed classification, with a view to the stomach. The prevention and diagnosis and treatment of cancer provide a more comprehensive and more targeted basis. Methods a retrospective analysis of the clinical data of 263 cases of gastric cancer diagnosed by Xuchang Hospital of Traditional Chinese Medicine from 01 months to 01 months from 2014 to 2015 was divided into young male group, middle-aged male group, old male group and young woman according to sex and the definition range of WHO for age in 2000. The clinicopathological differences between young men, middle-aged men and elderly men in Xuchang area, and the clinical pathological differences between young women, middle-aged women and older women were analyzed from a individualized perspective. The SPSS17.0 was used for young men, middle-aged men and elderly men. The data of group three were analyzed, for example, the difference was significant, and then 22 contrasts were made. The same method was used in women's age groups. In the 1. study, 263 cases of gastric cancer, 186 male and 77 female, 11 cases of young men and 16 young women, and the ratio of male and female to male and female. 1:1.45, 82 middle-aged men and 26 middle-aged women, the ratio of men and women was 3.15:1, 93 aged men and 35 elderly women, and the ratio of male and female to 2.66:1.2. was on the lesion. In general, the incidence of gastric cancer in Xuchang area was the gastric antral gastric fundus gastric fundus and the whole stomach. The incidence of gastric body in the elderly male was higher than that of the middle-aged men and two groups. There was no significant difference between the different age groups in the rest of the male patients (P0.05). There was no significant difference in the incidence of all parts of the age group of the female patients (P0.05), and there was no significant difference in the incidence of each age group (P0.05) in the general classification, the middle age male group in Xu Changdi district was significantly higher than that of the Borrmann type II. The elderly male group (P0.05). There was no significant difference in the composition ratio of all age groups in female patients (P0.05).4. in the organizational credit type, the proportion of differentiated adenocarcinoma in the elderly male group in Xuchang was significantly higher than that in the young male group and the middle age group (P0.05), and the composition ratio of the young male group in mucous adenocarcinoma was significantly higher than that of the old group. In the male group (P0.05). In female patients, the composition ratio of undifferentiated cancer was significantly higher in the young women group than in the elderly female group (P0.05).5. in the pathological stage. The composition ratio of the young male group in the Xuchang area was significantly higher than that in the middle age group (P0.05) in the TNM staging. Women in all age groups were in the constituent ratio of the TNM staging. There was no significant difference (P0.05).6. in clinical manifestations. In general, the most common clinical manifestations of gastric cancer in Xuchang were abdominal pain, followed by anorexia, hematemesis and stool. The incidence of upper abdominal pain in middle-aged men was higher than that of young men and old men (P0.05); the incidence of emaciation in the elderly male group was significantly higher than that of middle-aged men. Group (p0.001); the incidence of dysphagia in the elderly male group was significantly higher than that in the middle age group (p0.001). The incidence of emaciation in the elderly female group was higher than that of the middle-aged female group (P0.05). There was no significant difference in the incidence of various clinical manifestations among the other age groups (P0.05).7. in family history, smoking history and drinking history, Xuchang There was no significant difference between the male and female groups in the region (P0.05).8. in hypertension, diabetes and other complications, there was no significant difference between the male and female groups in Xuchang region (P0.05). Conclusion 1. Xuchang area, the incidence of male gastric cancer is higher than that of women, middle age gastric cancer patients have the highest proportion of men and women, young people with gastric cancer. Significantly higher than male.2. Xuchang young patients, especially young women with gastric cancer tissue morphology, biological behavior is significantly worse than the elderly patients, middle-aged patients with limited focus, middle-aged patients with abdominal pain symptoms and elderly patients with thin and dysphagia symptoms are more significant.
【學(xué)位授予單位】：新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R735.2

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